Date post: | 05-Dec-2015 |
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Case Report
Chronic osteomyelitis
•A 67-year-old female patient
• Complains of swelling in the lower teeth region
•Duration-13 years
Chief Complaint
History of Presenting Illness
•She consulted a hospital 11 years back. Biopsy was done and was diagnosed as osteoma.
•Noticed pus from the front teeth region on pressing 4 months back.
Clinical Examination
Extraoral
No abnormality detected.
Intraoral
Swelling of size 2 x 3 cms present on lingual aspect of 31, 32, 41, and 42 covered by normal mucosa.
On palpation it is firm, non mobile and non-tender.
Pus discharge from swelling
Provisional diagnosis:
•Osteoma• Florid cemento-osseous dysplasia• Late stage fibrous dysplasia•Osteoblastoma• Chronic osteomyelitis
Investigations OPG
Reveals multiple RCT done and missing teeth and bridges.Mixed radiolucent and radioopacity at apex irt 31, 32, 41, and
42.
Occlusal radiograph
Shows mixed radiolucency which is well circumscribed by radiolucency overlapping irt 31 and 32.
Histopathology
Ulcerated epithelium(10x)
Superficial stratified squamous epithelium
(10x)
Histopathology
Sheets of plasmacytoid cells in the connective tissue
10X 40X
Histopathology
Cellular and nuclear pleomorphism
HISTOPATHOLOGY
Vesiculated and hyperchromatic nuclei
peripheral chromatin condensation
HISTOPATHOLOGY
Binucleate plasma cells
Chronic diffuse sclerosing osteomyelitis